Handy Tips for Strengthening Hand Grip
Most of my clients love scooterboard activities.If they don’t love it when they first come to PT, it is not long before I wear them down, and they love it.I use this activity for both back/neck extension and hand strengthening. I use wedges to decrease the effect of gravity on the back/neck extension requirements when I believe that the child does not have the back/neck extension necessary to perform this activity without the wedges.Here I have placed a wedge on 2 scooterboards. I put down one vertical at the front and one horizontal in the back. I have placed some dycem down between the scooterboards and the wedge to make sure nothing slides.
If the child does not have the head control, sometimes I put down 2 wedges stacked. If you do this, put dycem (or any other nonskid stuff) down between the client and the wedges, or the child will slide down the wedge hill. If I have any concern of the child falling off the scooterboard, I put a belt around the child and the scooterboards to secure him down.I may also have a helper simply walk along beside the child and press down on the child’s low back for stability. In this picture the child is holding onto a hoop to go. Sometimes a child tries to hold on with his hands supinated. I always switch his hands to pronated.
If a child is having a really hard time with grasp, I let the child hold onto me instead of the hoop. I usually put out my index finger and middle finger for the child to grasp perpendicular to the child.I position my thumbs to be ready to grasp the child if he can’t keep the grip.There is always resistance to overcome when the scooterboard starts moving so I may initially hold onto the child and then once we get over the momentum I try to get the child to maintain grasp on my fingers or on the hoop. I hope the child figures out how to maintain grip on my hands quickly because this is back breaking work. I switch as soon as I can to having the child hold onto a hoop so I can stand up properly.
Remember the floor’s surface significantly affects the level of difficulty this exercise is with your client. Hard slick floor like vinyl tile or wood flooring is the easiest, followed by thin carpet. Thick carpet is the most resistant. So modify the flooring your traverse according to the child’s strength.
If the child is much larger, like a teenager, I put down the 2 scooterboards, both horizontal and spaced out. Then I put a platform swing on top of them, leaving the ropes on top. Then I put the wedges(s) on top of that for a much wider and longer scooterboard.This is not as stable as it would seem. It also is more wieldy to turn. A parent helping with the turns and holding open doors to prevent obstacles is critical. Be careful on changes of surfaces, such as moving from the carpet to the lineoleum. It is not uncommon for the front scooterboard to get caught up on the floor transition. The whole thing gets top heavy and …well…I’ve had some near crashes. …and lots of giggling.
I can challenge a child slightly more with the grasp by speeding up and slowing down the scooterboard. Turns also affect the strength requirements. If you pull the child turning the scooterboard to his left, his right hand is working harder. If you pull the child turning the scooterboard to his right, his left hand is working harder. I go in a circuit around the building, so sometimes I go intentionally clockwise or counterclockwise around the building to purposefully make one hand work harder or reduce the requirements for hand strength on one hand.
For documentation purposes, I note the angle of the incline and the amount of time the child is able to keep his grip on the hoop.
